Michelle Noteboom: Give me an overview of InterSystems and clarify your role in the company.
Nelson Le: InterSystems is a global healthcare IT company and we have different products that we offer the market. We say that technology is the pathway to making an impact in healthcare. The team that I work on is focused on interoperability and our position is that in order to achieve clinical outcomes and to perform well as a healthcare system, you need to be able to be interoperable and connect all your different systems, your different stakeholders, and all the data that you have regarding your patients and your performance.
My role on the team is clinical adviser. What that means is that I look at our products and solutions, I look at our positioning, and I look at our customer base and figure out how we can use technology to drive strong clinical outcomes.
MN: How does interoperability benefit healthcare organizations from a clinical standpoint and as well as the operational and financial perspective?
NL: With the changing landscape of healthcare and payment reform, lots of hospitals are now forming relationships with new partners and new facilities that they never had before. When you couple that with the fact that patients now are seeing many physicians because they’re living longer and there are more chronic disease states, you see this complex network of patients seeing more providers and hospitals being connected to different facilities. There is all these data that’s floating around in silos.
In order to really achieve better outcomes, you need to be able to have an interoperability platform that connects all of these data points because otherwise, you’re seeing only part of the patient, only part of their problem list, and part of their medications. That’s when you run into trouble with medical errors because you end up not being able to accurately diagnose and treat your patients.
The position we take is that interoperability is the missing piece of the puzzle and without that, there’s no way you can deliver good care, operate efficiently, and meet your payment reform contracts to maximize your outcomes and your revenue.
MN: In the last two or three years have you seen more organizations actually asking for these additional tools because of the new payment models?
NL: Yes. When we look at our customer base, most of the larger customers are either in an ACO contract or they’re in a risk-sharing model. It’s definitely increasing over time.
It’s a theme that’s important to our customers, so we are aligned with that theme. Everyone is realizing that with these new contracts and partnerships, it’s almost impossible to understand how you’re performing and how well your patients are doing without seeing all your data and sharing that data.
Also with these contracts, we’re now being asked to perform some pretty high level analytics to understand risk stratification and population health management and the only way to do that is to actually have data for your entire population.
MN: What makes the HealthShare platform unique in comparison to other information sharing and analytics solutions on the market right now?
NL: When you look at the technology offerings within the industry, I bucket them into three areas. The first area includes technologies that are really great at capturing information and those are your traditional electronic medical records. And then there are also technologies that are good at sharing information. Those are your integration engines. The third bucket I see are third-party solutions that are really good at doing analytics. These are the companies that can take it and analyze it and then give you the result. But the problem with that is when you’re trying to piece those things together, there is a time lag and a data latency between taking the data in, sharing it, and then also syncing it up to be analyzed.
Where we are different than other companies is that our platform incorporates all three technologies within one stack. When the data comes into HealthShare, it’s being shared right away and then also, being analyzed without much time delay. That’s really an important piece and that’s the one that we’re proud of. By tying all these technology into one solution a customer knows that they can do all those things rather than relying on parts from different technologies. That’s where we’re different.
MN: There has been a lot of talk lately about data blocking on the part of vendors and providers. Do you see much evidence of data blocking and is it hindering interoperability efforts in the industry?
NL: We do see that in certain environments, but usually those systems are pretty insular and they are probably still operating in a fee-for-service model. In a risk-sharing model and in ACO models and when operating in health information exchanges, stakeholders and institutions have already agreed that sharing data is a necessity. It’s not an option; it’s a necessity for that organization to function well. That’s where I think it gets interesting because you might be collaborating and cooperating and coordinating with your former competitors.
Those decisions are only made at the high level and then people follow suit. That’s also an important factor when we are looking at our customers to see who is ready for an interoperability platform. If you’re in a competitive environment, I can understand that data blocking might be an issue, but in an environment where you have to work together, data sharing a necessary function.
MN: Tell me how patient engagement comes into play within the whole interoperability platform.
NL: That’s a good question because I know that patient engagement is a hot topic right now. When you think about a typical patient, they may go see an outpatient physician. They might have an admission to the hospital, they might go to CVS Pharmacy, and all their information might come from different doctors. All these doctors might be using different technologies and for each of these places, you have different portals.
You have an outpatient portal that you have to access to see your information; you have an inpatient portal; you have your pharmacy data; you have your insurance data. It makes it very cumbersome. I don’t know about you but I have trouble remembering just the couple of passwords I already have.
When you have seven passwords for a patient in seven different accounts, it’s a problem from a clinical perspective. When those patients go into a record, they only see what happened with that specific episode. They don’t see their entire health record. That’s not delivering good care.
Our position is that if we can pull all this data together, why not have a one stop shopping experience? The patient logs into one portal and when they open up that record, they see all the information. On the back end, what HealthShare does is pull that data together. We present it in one view so the patient can go in and see all their information, all their medication lists, look at their insurance data, request prescription refills, and request appointments using one interface, rather than going to multiple different areas.
MN: What will InterSystems being talking about at the CHIME meeting?
NL: One of the things is our work with the Missouri Health Connection, which is that state’s health information exchange. We are looking at how we can capture data regarding return on investment. Return on investment is another hot topic right now with healthcare IT in general. We have all these technologies and want to know what the return is from a clinical perspective, financial, and operations.
The data in the literature and the industry definitely states that there is a return on investment, but we’re trying to quantify that information. We know having an interoperability platform really helps you reduce your medication errors. It reduces the number of readmissions to your hospital and also can impact those medication areas in general.
When you share information with all your providers and you share that information with your patients as well, you engage patients after they leave the hospital. You definitely have an impact that can improve your clinical outcomes and your financial and operational performance.
The abstract that we are using at the CHIME Performance Institute Solutions Showcase talks about how Missouri Health Connection is using their data from their health information exchange, which is built on HealthShare, to quantify the return on investment.
MN: Have they been able to quantify returns yet?
NL: Yes. Their estimate is that by using the health information exchange they’ve been able to improve on readmissions and improve their medication errors, and also improve and reduce the number of malpractice litigations. Their anticipated return on investment annually is about $12.8 million. If you take the cost per episode of medication error and the cost of each readmission and multiply that by your entire patient population, you can see how those numbers can really add up quickly.